Priya Shekar, Janaki Pearson, Sharon Scully
Freeman Hospital, Newcastle upon Tyne, United Kingdom
Introduction: A purpose built day treatment centre at the Freeman Hospital opened in October 2023. BADS and the Association of Anaesthetists recommend a protocolised postoperative pathway in order to facilitate nurse-led discharge following day surgery1. Therefore, in order to safely undertake day case surgery under spinal anaesthesia in our new facility, a ‘Safe to Stand’ proforma was implemented.
Methods: Day case staff involved in the postoperative care of patients following spinal anaesthesia were surveyed. This highlighted insufficient prior training and a lack of confidence in assessing this group of patients. Subsequently a day case guideline was written including a Safe to Stand Post Spinal proforma, which had been developed by Airedale General Hospital2. Staff were educated how to use the proforma correctly assessing patients motor, sensory and proprioception functions.
Results: Three months following implementation, the electronic records of all patients who underwent spinal anaesthesia were reviewed for the presence of a safe to stand proforma. Compliance was 100%, however 78% were incomplete with no time of discharge documented. Further education was done and following this 100% of safe to stand proformas were correctly completed. Day case staff were re-surveyed; this showed increased levels in confidence and positive feedback for having formal guidance regarding timing and regularity of patient assessment, and clear criteria to be met prior to safe mobilisation.
Conclusion: In conclusion, the initiation of a protocolised pathway has facilitated safe and efficient nurse-led assessment and discharge of day case patients post spinal anaesthesia in our new day case facility.